Expiratory Velopharyngeal Obstruction: Sleep Endoscopy-Guided Treatment Strategies to Prevent Oral Breathing During Sleep.
drug‐induced sleep endoscopy
expiratory velopharyngeal obstruction
head rotation
iNAP
mouth closure
mouth puffing
obstructive sleep apnea
oral appliance
oral breathing
target‐controlled infusion
Journal
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
ISSN: 1097-6817
Titre abrégé: Otolaryngol Head Neck Surg
Pays: England
ID NLM: 8508176
Informations de publication
Date de publication:
21 Jul 2024
21 Jul 2024
Historique:
revised:
05
06
2024
received:
16
11
2023
accepted:
27
06
2024
medline:
21
7
2024
pubmed:
21
7
2024
entrez:
21
7
2024
Statut:
aheadofprint
Résumé
Obstructive sleep apnea (OSA) is a prevalent disorder, with oral breathing influencing its severity. Expiratory velopharyngeal obstruction (EVO), observed during drug-induced sleep endoscopy (DISE), may contribute to oral breathing in OSA patients. EVO results in obstruction between the pharynx and nasal cavity during expiration. This study aims to identify factors associated with positive EVO during DISE. Case series. Tertiary Medical Center. Seventy-two OSA patients underwent clinical evaluation, polysomnography, and DISE, utilizing interventions like intraoral negative airway pressure (iNAP), mouth closure, and oral appliances (OAs) in supine positions with head rotation. The findings, classified under velopharynx, oropharynx, tongue base, epiglottis, included the presence of EVO. The results demonstrated that interventions including mouth closure and iNAP were associated with increased observation of EVO (43.1% and 34.7%) compared to OA (20.1%). However, head rotation was associated with decreased presence of EVO during DISE compare to supine (26% vs 35.8%). Noticeably, per 1 year increase of age was associated with an increased odds of EVO (odds ratio: 1.03, 95% confidence interval: 1.01-1.06). However, no other baseline characteristics were significantly associated the odds of EVO. Our study reveals the effectiveness of head rotation and OA in reducing EVO and improving mouth breathing in OSA patients, offering valuable insights for future treatment strategies.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024 American Academy of Otolaryngology–Head and Neck Surgery Foundation.
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